Provider Demographics
NPI:1851597546
Name:LUDDY, ARLEEN WENDY
Entity type:Individual
Prefix:MRS
First Name:ARLEEN
Middle Name:WENDY
Last Name:LUDDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MORGAN LANE
Mailing Address - Street 2:
Mailing Address - City:POUGHQUAG
Mailing Address - State:NY
Mailing Address - Zip Code:12570
Mailing Address - Country:US
Mailing Address - Phone:845-221-1398
Mailing Address - Fax:
Practice Address - Street 1:49 LOWER SHAD ROAD
Practice Address - Street 2:
Practice Address - City:POUND RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10576-2216
Practice Address - Country:US
Practice Address - Phone:914-764-4416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4524111163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01410246Medicaid